Leads

Doesn't make any sense to me

by AgentX86 - 2020-07-11 07:21:51

If you'd said that you bottom (ventricle) lead been shut off  i could understand it. In some cases the ventricular lead is pur in "just in case".

You give no information of your current (foirmer) condition, reason for pacing, or pacing mode. I can only guess what's going on.

If you're paced V-only, even part of the time, you'll give up AV synchrony with only a ventricular lead. If it only happens at times, you'll certainly feel it as synchrony comes and goes. If your problem is sick sinus syndrome or a low grade AV block, this is what will happen.

I'd certainly question this. It sounds like someone wants to save money. This is an excellent example of why everyone needs to know as much as possible about their condition, exactly why they have a pacemaker, and their pacing mode(s).

old leads

by Tracey_E - 2020-07-11 09:46:16

Agent, pretty sure it's not about money but about putting off what will be a serious surgery. 20+ year old leads do not come out easily and have their own set of problems, so they treat us differently than someone with much newer bad leads. 

We can often get by just fine with av block with just the ventricle lead. For a long time, that's all they ever used for av block. Two leads is ideal but one will do in a pinch and get you by until the battery needs replaced and you can take care of both at once. 

Have they checked to make sure you don't have room for another atrial lead? When one of my leads went bad they did an iv with dye in the cath lab to see if I had room for more. I did, so when the battery was ready to be replaced, they capped off the bad one (it's still in there), added the new one. That was 10 years ago. 

My other original lead is 26 years old and is still going strong. My doc does an xray every year to look for minute damage as well as the most thorough echo I've ever had to keep an eye on scar tissue. We have a plan for when one goes bad, but for now my 26 year old lead is holding up just fine. 

Gellia, one of our members who I haven't heard from in a while had one of the very first two lead pacers and has one working lead that's well over 30 years old. We have a few other members who have been paced more than 30 years, pretty sure some of them still have original leads. 

So, to answer your question, I don't know that another 20 years is realistic but who knows? Maybe you'll set the record. I know of a small handful of people who have made it to 30 years on a lead. I plan to eek every bit of life out of my current leads. I'm 53 now so I hope to hold off extracting long enough that my next set is my last, or that they'll perfect leadless pacing or any of the other exciting technologies out there before I need it. 

Heart Block???

by AgentX86 - 2020-07-11 11:15:45

First, we don't know that the problem is heart block.  It could be SSS for all we know.  Second, the pacer would have to be set to VVI mode which is not recommended anymore for heart block, particularly without CRT or His pacing.  VVI guarantees AV dyssynchrony,  and worse, if it's not a 3rd degree block (again, not stated), the pacing will go in and out of synchrony.  That can't be good.  AV dyssynchrony isn't the end of the world but it's certainly something to be avoided when possible and it is possible here.

Yes, removing old leads is difficult but just reading here, it's becoming pretty standard stuff.  There also may be room for another lead (again, unknown or not stated). 

There just isn't enough information here and I still say it's a bad move, particularly without informatoin/challenge. I'd want to know WHY this is what they're doing and what the a;ternatives are.  It just doesn't make sense and isn't in the patient's best interest, IMO.  Answers!  None have been offered, so far.

what was the question

by Tracey_E - 2020-07-11 21:47:09

The question was how long can leads keep on working. Nowhere did she ask our opinion on the decisions her doctor has made. 

old timers

by Tracey_E - 2020-07-11 22:11:24

Dug this up, it's 10 years old now. He's been paced since 1968! Gellia responded, so you can click on her name and get to her posts from there

https://pacemakerclub.com/message/8168/who-has-lived-the-longest-with-a-pacemaker

and this one

https://pacemakerclub.com/message/33574/longest-time

this is the more recent post I was thinking of, but no mention of the age of his leads. The post is new enough you might be able to message him. 

https://pacemakerclub.com/message/36787/who-has-lived-longest-with-a-pacemaker

long time

by dwelch - 2020-07-11 22:51:58

I have CCHB.  I have one working 33 year old lead, one broken 33 year old lead.  One working 26 year old lead, and my current pacer is a biventrical and so a few year old lead.  Four leads I am using three of them.   Leads are different brands, Id have to get my card to list them.

And I have my first three pacers, number three I got lucky and number four they wouldnt let me have, and I dont expect to be able to get any more of them (on device number 5).  Not remotely as long as some of the links Tracey posted and some folks I have seen here as well over the years.